The Care Quality Commission (CQC) has rated four east London urgent treatment centres inadequate and placed them in special measures, following inspections in October and November.
The services, which are run by the Partnership of East London Co-operatives (PELC) Limited, are:
- King George's Emergency Urgent Care Centre (EUCC) in Goodmayes
- Queens Urgent Treatment Centre in Romford
- Harold Wood Urgent Treatment Centre in Harold Wood
- Barking Urgent Treatment Centre in Barking.
People receive treatment for minor injuries and illnesses at the services, and access referrals to other services more able to meet their needs, after self-referring or being advised to attend by NHS 111.
PELC provides these services under contract from the NHS.
Three of the four inspections were undertaken to assess whether improvements which previous inspections identified as being needed had been made.
The inspections also formed part of a follow-up on CQC’s system-wide review of urgent and emergency care services across the North East London integrated care system, carried out in November 2021.
CQC found the quality and safety of care provided to people at the services had deteriorated compared to previous inspections, leading to each service being rated inadequate.
CQC has also placed the services in special measures. This means they are being closely monitored, and they will be inspected again in the coming months to assess whether improvements have been made.
King George's Emergency Urgent Care Centre was previously rated good, while the other services were rated requires improvement.
Jane Ray, CQC deputy director for London, said:
“We found people didn’t receive care and treatment in a timely way at PELC’s services.
“Although each service suffered from short staffing, which was a factor behind the long waits and an issue affecting the NHS more widely, PELC’s leaders must prioritise meeting NHS England’s standard of clinically assessing people within 15 minutes of arrival. This is to ensure those with the most critical needs receive urgent care and treatment.
“Behind this was the failure of the service’s leaders to effectively monitor issues the services faced, including waiting times, to inform their strategies to meet people’s needs. They also failed to capture learning when things had gone wrong to drive improvement.
“However, despite the pressure they were under, staff in each service treated people with kindness, respect and compassion. They involved people in decisions about their care and ensured their dignity.
“We have reported our findings to PELC’s leaders so they know where improvements must be made, and we will return to assess whether there’s been progress.”
The inspections found:
- PELC could not be assured it was providing safe care to people, particularly those with potentially serious conditions
- There were insufficient procedures and processes to ensure learning from incidents and complaints. There were not clear systems in place to demonstrate improvements when things went wrong
- The effectiveness and appropriateness of care was routinely reviewed, and care and treatment were delivered according to evidence-based guidelines. However, targets specified by its commissioners were not being met
- There were insufficient procedures to ensure there was effective staffing
- Patients were not able to access care and treatment at the service in a timely way
- Leaders did not have the capacity and skills to deliver high-quality, sustainable care
- There were some clear responsibilities, roles and systems of accountability to support good governance and management. However, lines of accountability and designated decision-making authority were unclear
- PELC lacked a clear vision and credible strategy to deliver high quality care and promote good outcomes for patients through the services.
However:
- Staff involved and treated people with compassion, kindness, dignity and respect.